经皮冠状动脉介入治疗对冠心病患者髓过氧化物酶水平的影响

目的 探讨经皮冠状动脉介入（PCI）术对冠心病患者外周血髓过氧化物酶（MPO）水平的影响.方法 选取149例冠状动脉造影检查确诊冠心病的患者,按临床类型分为急性心肌梗死组（AMI组,67例）、不稳定心绞痛组（UAP组,42例）、稳定性心绞痛组（SAP组,40例）.各冠心病组根据是否行PCI治疗再分别分为AMI支架组和AMI造影组,UAP支架组和UAP造影组,SAP支架组和SAP造影组.并将15例经冠状动脉造影检查排除冠心病的患者作为非冠心病组（NC组）.用酶联免疫吸附法检测术前和术后30分钟、4小时、12小时、24小时的MPO和高敏C反应蛋白（hs-CRP）水平.结果 （1）术前AMI组的MPO和hs-CRP水平显著高于UAP组、SAP组和NC组（P＜0.01）;UAP组两者均高于SAP组和NC组（P ＜0.05）;SAP组的MPO水平高于NC组（P＜0.01）,两组间的hs-CRP水平比较差异无统计学意义（P＞0.05）.术前MPO水平与hs-CRP水平显著相关（r=0.701,P＜0.01）.（2）各支架组术后30分钟、4小时时的MPO水平均高于术前（P＜0.01）,AMI支架组、UAP支架组、SAP支架组分别于术后4小时、30分钟、30分钟达高峰后很快下降至术前水平.各支架组患者的hs-CRP浓度则逐渐升高,hs-CRP浓度的升高晚于MPO.AMI造影组的MPO和hs-CRP均呈逐渐升高的趋势,而UAP造影组、SAP造影组及NC组MPO、hs-CRP水平造影前后均无明显变化（P＞0.05）.结论 MPO是预测斑块稳定性的敏感指标;介入治疗可致冠心病患者PCI术后早期MPO水平表达增加,即使是斑块处于稳定状态的稳定性心绞痛患者.

Effect of percutaneous coronary intervention on myeloperoxidase levels in patients with coronary heart disease

Objective To investigate the influence of percutaneous coronary intervention（PCI） on myeloperoxidase（MPO） levels of patients with coronary heart disease（CHD）.Methods The total of 149 patients with CHD diagnosed by coronary angioplasty（CAG） were enrolled in this study,including 67 cases of acute myocardial infarction（AMI）,42 cases of unstable angina（UAP） and 40 cases of stable angna（SAP）.These three groups were divided into six groups,including the AMI stent group,the AMI angioplasty group,the UAP stent group,the UAP angioplasty group,the SAP stent group and the SAP angioplasty group,according to whether treated by PCI.And 15 patients without CHD diagnosed by CAG were selected as the control（NC group）.Serial sampling starting before arteriography（baseline） and continued up to 24 h after operation was carried out in all patients for MPO and high-sensitivity C-reactive protein （hs-CRP）,which were measured by enzyme-linked inmunosorbant assay（ELISA）.Results The levels of MPO and hs-CRP at baseline of AMI group were higher than the other three groups obviously（P 〈 0.01） ; The two factors of the UAP group were higher than the SAP group and NC group（P 〈 0.05） ;The level of MPO was higher in the SAP group than the NC group（P 〈0.01）,but there was no difference in hs-CRP （P 〉 0.05）.The level of MPO significantly associated with hs-CRP at baseline （r =0.701,P 〈 0.01）.The levels of MPO at 30 min and 4 h after PCI in the three stent groups were higher than baseline（P 〈 0.01）.The AMI group stent reached a peak at 4 h after PCI,and the UAP stent group and SAP stent group reached the peak at 30 min,30 min,respectively.But,the levels of MPO quickly returned to baseline after reached to the peak（P 〉 0.05）.The levels of hs-CRP in these three groups all showed a trend of gradually increasing.However,the peak of hs-CRP had not appeared within 24 h.The levels of MPO and hs-CRP in the AMI angioplasty group showed a trend of graduall increasing,but the increasing amplitude were much lower than the AMI stent group.No change was found in the UAP and SAP angioplasty group of the two factors at different time points（P 〉 0.05）.Conclusion MPO maybe a sensitive index to predict the stability of plaque.Interventional treatment can promote to increase of plasma level of MPO after PCI,even to patients with stable angina pectoris.